'A little lipo with your facial, madam?'

Image caption Serious procedures like facelifts should not be classed with 'minor beauty procedures'

The number of people having both cosmetic surgery and beauty treatments such as botox are increasing.

But in this week's Scrubbing Up, consultant plastic surgeon Fazel Fatah, president of the British Association of Aesthetic Plastic Surgeons (BAAPS), warns lines between the two are being blurred, and more effective regulation is needed.

You wouldn't trust your boiler to an unqualified engineer - so why do people continue to trust their face and body to untrained practitioners?

There is a difference between plastic surgery - facelifts, breast enhancement, tummy tucks, liposuction, etc - and cosmetic salon treatments such as lasers, peels and injectable fillers.

But the two are being confused in a way that trivialises surgery and puts patients in real danger.

Alarmingly, there are many practitioners offering procedures that require specialised surgical training and expertise which they do not have - and there is no regulation whatsoever to protect the public.

Theme parties

The beauty industry, like any other, has a legitimate right to maximize profit through honest marketing while providing a service to the customers.

However, bundling cosmetic surgery under the same terminology turns medical treatment into a commodity.

There is a clear risk to the public here and one I come across regularly when dissatisfied people come for advice, after having undergone a procedure they regret: cross selling.

While you may think there is nothing unethical about encouraging customers to buy two items from a shop when they intend to only buy one, it is highly unethical to cross sell serious medical procedures to an unwitting customer when she or he goes simply to have a non-invasive beauty treatment or injections to reduce wrinkles.

Unlike those, surgery carries risks and serious complications can happen, however rare they may be.

The less-invasive procedures, such as fillers and wrinkle-reducing injections, along with beauty treatments such as lasers and peels are offered by a range of professionals, including beauty therapists, dermatologists, GPs and dentists - some better trained than others.

And unfortunately, anybody can buy injectables on the internet and have a theme party in someone's front room.

While cosmetic treatment may be for vanity, the reasons for having aesthetic plastic surgery are more complex.

Done for the right reason, the reward is a significant enhancement of the wellbeing and quality of life for the patient.


The real risk to patients from bundling cosmetic surgery with beauty industry emanates from the lack of enforceable regulations from the government.

The death of a trusting young woman from the UK in a New York hotel room after a silicone injection could happen here too.

The continual eroding of the line between what's considered 'surgical' and what's considered a simple beauty treatment or cosmetic medicine in the UK has lead some medically qualified doctors, who do not have surgical qualifications, to expand their cosmetic medicine to include surgical procedures.

Even more alarming, controversial treatments such as stem cell injection for breast enhancement are currently being offered to trusting women by some private clinics in London.

Misleading promises from an unproven technique that is still the subject of research in many countries puts patients at risk and it is unethical.

Such treatments must only be provided in specialist units and by qualified specialists as part of clinical trials to assess its safety and efficacy.

Let's be clear - cosmetic or aesthetic surgery is a branch of plastic and reconstructive surgery.

To become a plastic surgeon you have to go through a six-year program of specialist surgical training after qualifying as a doctor and finishing the basic surgical training.

You also have to pass a specialty examination.

Many qualified plastic surgeons also the undertake further specialist training.

And patient safety is at the heart of it all, before all other considerations - particularly financial interests.


The public expect surgical treatments to be provided by qualified specialists only, and they believe this to be the case.

Sadly, due to lack of regulations in the UK, this is simply not true.

We have now reached a stage where legislation is required to regulate the practice of surgery to protect the public from unqualified practitioners who perform surgery and for qualified surgeons to operate within the boundaries of their specialty.

The public deserves better and we are now falling behind some of the European countries in this respect.

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